初级保健中阿尔茨海默病老年人协作护理的有效性:一个随机对照试验
Christopher M Callahan1, Malaz A Boustani, Frederick W Unverzagt
1Indiana University Center for Aging Research, Regenstrief Institute Inc, Indiana University School of Medicine, Indianapolis 46202, USA. ccallaha@iupui.edu
JAMA
|May 11, 2006
概括
协作护理模式显著改善了阿尔茨海默病护理质量,并减少了初级保健中的行为症状. 照顾者还报告说,他们的痛苦和抑郁也减少了.
科学领域:
- 老年学是指老年学的学科.
- 初级医疗保健医学 一级医疗保健医学
- 神经学 神经学
背景情况:
- 初级保健医生经常管理痴呆症护理,面临实践环境挑战.
- 优质的痴呆症护理对老年人和他们的护理人员至关重要.
- 阿尔茨海默病 (AD) 在初级保健机构内需要专门的管理策略.
研究的目的:
- 评估协作护理模式在提高阿尔茨海默病患者护理质量的有效性.
- 评估综合护理对患者结果和护理人员幸福感的影响.
- 为了确定合作护理是否可以改善痴呆症 (BPSD) 的行为和心理症状的管理.
主要方法:
- 一项受控的临床试验涉及153名阿尔茨海默病老年人和他们的护理人员.
- 将参与者随机分配到协作护理管理或增强常规护理.
- 干预涉及1年的护理管理由一个由高级实践护士领导的跨学科团队,专注于BPSD的非药物管理.
主要成果:
- 协作护理患者更有可能接受胆酶抑制剂和抗抑郁药.
- 在12个月和18个月 (NPI分数) 观察到痴呆症 (BPSD) 的行为和心理症状显著减少.
- 护理人员报告说,痛苦和抑郁症症状显著改善.
结论:
- 协作护理模式有效地提高了初级保健机构中阿尔茨海默病护理的质量.
- 这种模式导致BPSD的显著减少,并提高了护理人员的幸福感.
- 在不增加抗精神病药物或镇静催眠药的使用的情况下实现了改善.
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